(Image by Maria Guerrero via Pixabay)

WEDNESDAY IS EARTH DAY, and communities across Massachusetts are coming together to celebrate and protect our environment, from cleaning up local parks to advancing climate solutions that safeguard our future. But this year, that celebration comes with a stark reminder: our ability to fight climate change – and the threats it poses to public health – is at risk.

As the state’s chief law enforcement officer and as a physician, we see the same reality from different vantage points – and we share a responsibility to act.

That responsibility depends on the tools we have to prevent harm in the first place. And it’s why the US Environmental Protection Agency’s rescission in February of the 2009 Endangerment Finding is so alarming. The Endangerment Finding is the scientific determination that motor vehicle greenhouse gas emissions threaten public health and welfare.

More than 20 years ago, Massachusetts led the fight to compel EPA to determine whether greenhouse gases harm our health and welfare. The resulting Supreme Court decision, Massachusetts v. EPA, led to EPA’s Endangerment Finding. It has served as the backbone of action under the Clean Air Act to limit pollution from motor vehicles, the nation’s largest source of greenhouse gas emissions.

As a physician in Massachusetts, one of us sees the health impacts of climate change every day. Last summer, during a heat wave, a patient came to the primary care clinic at Boston Medical Center exhausted and dizzy. She lived on the top floor of a triple-decker with her children and could not afford an air conditioner. They relied on fans to stay cool during the hottest days. A medication she takes made it harder for her body to regulate temperature, worsening her dehydration and putting her health at real risk.

Her visit made clear how climate change is not an abstract threat, but a daily health risk for patients already navigating financial and medical hardship.

On the legal front, Massachusetts led the charge two decades ago, and that’s why today, we’re leading once again. Last month, the Massachusetts attorney general’s office led a coalition of states in suing to block the Trump administration’s unlawful rollback of the Endangerment Finding and federal limits on vehicle emissions. The office is doing this not only because it’s both scientifically and legally wrong, but also because it is a public health imperative.

Across Massachusetts, the health impacts of climate change are already visible and growing. Average temperatures have risen by about 3.5 degrees Fahrenheit over the past century, and we are projected to experience significantly more days above 90 degrees each year.

Extreme heat is not just uncomfortable. It’s dangerous. It increases heat-related illness and death and is already contributing to preventable mortality in Massachusetts, with projections showing that without action, extreme temperatures could be responsible for hundreds of additional deaths annually by the end of the century.

Climate change is also worsening air quality, with direct consequences for respiratory health. In Massachusetts, where nearly 1 in 10 children already suffer from asthma, rising temperatures accelerate the formation of ground-level ozone, a pollutant that impairs lung function and triggers asthma attacks. This leads to more emergency room visits, more missed school days, and more families managing chronic illness that is both preventable and exacerbated by environmental conditions.

Hospitals are caring for more and more patients with heat-related exacerbations of chronic conditions like heart disease, kidney failure, and psychiatric illness. Tick-borne illnesses such as Lyme and babesiosis are also becoming more common due to changing weather driven by climate change. Tiny airborne particles from motor vehicle pollution not only worsen asthma and other lung diseases but also are linked with dementia and autism.

These harms do not fall evenly. Environmental and health burdens are often concentrated in low-income communities and communities of color, communities that have historically borne the brunt of pollution and underinvestment. These communities are also more likely to have underlying health conditions that make climate-related exposures more dangerous. Rescinding the Endangerment Finding and all federal motor vehicle greenhouse gas emission standards will deepen these inequities, leaving our most vulnerable residents even more exposed.

Massachusetts has long been a leader in confronting climate change, from investing in clean energy to setting ambitious emission reduction targets. We have shown that it is possible to grow our economy while reducing pollution and protecting public health. But we cannot do it alone.

Federal pollution standards establish a baseline of protection and ensure harmful pollution is reduced nationwide. If those standards are rolled back, states will be forced to pick up the pieces – with fewer tools, higher costs, and greater risk. In the meantime, residents will pay the price in their health, their homes, and their communities.

Strong public health protections help prevent illness before it starts. When those protections are weakened, it becomes harder to keep people healthy and safe. Policies that reduce pollution are central to public health.

That’s why this moment is about more than litigation. It is about whether we will continue to make public health decisions based on science or allow politics to override evidence at the expense of people’s safety. It is about whether we move forward with urgency and purpose or retreat from the very tools that have helped achieve meaningful progress.

On Earth Day, we should be moving forward – strengthening protections, investing in resilient communities and ensuring that every resident, in every corner of our state, can breathe clean air and live, play, worship, and go to school in a safe environment. Rescinding the Endangerment Finding takes us in the wrong direction. Massachusetts will continue to stand up, speak out and fight for the protections our residents deserve.

Andrea Campbell is the attorney general of Massachusetts. Anna Goldman is a primary care physician and medical director of sustainability at Boston Medical Center.